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Happy birthday little one…

The reason that there are so many tests is that I literally couldn’t believe it. My lovely IF friends in the computer encouraged me (aka pee-pushed me) into taking dozens of tests in the hopes of getting me to accept what was so very clear to their eyes. I was pregnant.

My disbelief stemmed partly from the sheer newness of a positive test after over a year of negative ones, as well as the unlikely scenario that led to that second pink line. For that pregnancy cycle, my period started on August 26, I flew to New Orleans for a family vacation/family wedding combo on October 17 (CD53), enjoyed oodles of vacation sex, ovulated on my own on October 19 (CD55), rang in my 28th birthday in a NOLA jazz bar with plenty of libations on October 20 (CD56), returned to plain old life and home on October 24 (CD60), and saw those lovely lines on October 30 (CD66/11dpo). To say the result was unlikely is an understatement. And, this was long before knowing all I know now about my endo-riddled organs. I couldn’t help but laugh (or at least “LOL”) when I wrote to my IF friends in the computer, “I guess all I had to do to get pregnant was take a vacation afterall! Grumble…” For once, it seemed, the odds were in my favor.

As I welcomed the constant parade of trick-or-treaters in our family-friendly neighborhood, from the front porch of our first house that we bought to hold our future family, all I could think about was how the following year I’d have a little pumpkin of my own. So, on Halloween night as I went to the bathroom in the spare quiet moment between fueling hordes of candy-craved princesses and monsters, I was startled to see a bit of pink on the toilet paper as I wiped. I’d been in the TTC game long enough to know it’s premature to fret over small amounts of blood in the early days of pregnancy, but I was terrified. I called my OB the following day and, after pleading with the nurse on call, they agreed to draw a beta. Then there was more blood, more frantic calls to the OB nurse from the broom closet of my former work space, and more betas. Then the cramping picked up, my fingers started turning blue, and I made a few more calls. My betas were initially good, but then started acting strangely. They rose, but not enough. The OB nurse was nonchalant throughout it all. When she did bother to return my calls, she’d offer me helpful advice like, “Start getting used to the little pains of pregnancy!” or “Spotting is totally normal at this point” or “We don’t believe in testing progesterone, supplements won’t do anything anyway.” When, in the fifth week of my pregnancy the cramping escalated and the bleeding continued, I started asking for the nurse to discuss my case with the doctor. As I entered the sixth week my beta was just shy of 500. The ever on-again/off-again (and currently off-again) betabase.info lists the median beta for that stage of pregnancy to be 10,936. Something was wrong, and the odds weren’t in my favor.

After what must have been my 7th or 8th “please help me I’m worried” call to the OB, she agreed to send me for an early ultrasound at a local imaging facility. I was just around 5 weeks. As Mr. But IF and I sat there anxiously, the tech poked my overfull bladder with the abdominal probe since my ultrasound had been ordered in the same fashion as one would be for a woman much further along in her pregnancy. Not surprisingly, nothing was visualized abdominally, so we switched up to trans-vag. It was my second ever trans-vag ultrasound, with the only prior one coming when I forced my GP to send me for testing for PCOS in 2009 in an attempt to help us decide when we should start trying to conceive. But, that GP sent me for an ultrasound while on birth control (“It doesn’t matter, they can tell either way!”), so visit #1 with Mr. Wandy was a total waste of time. This would be the first that really mattered. And, she saw nothing.

At some point between the end of my fifth week and the start of my sixth, the combo of my empty uterus and abnormal betas finally started to concern my OB. She went from failing to return my calls to scheduling me in for an emergency appointment in the matter of two days. When we arrived to the busy OB waiting room for my “we’ll squeeze you in” mid-day appointment, we had no clue what the visit might entail. As incredibly pregnant woman after incredibly pregnant woman went back for their visits, my heart raced, my hands shook, Mr. But IF scowled. When we were finally taken back over an hour late for our appointment, the nurse got in a fight with me over the name of the brand of prenatals I’d been taking (“I need the name to enter it into your chart!”). I cried as the pictures of plump and happy babies stared down at me from the exam room walls. When the doctor entered she matter-of-factly outlined our options. “It’s an ectopic pregnancy,” she said. “You’ve got three choices, but there’s really only one I’d recommend. First, we do a D&C, but that’s probably pointless because I don’t think we’re going to find anything. Second, you wait and continue to do betas. I will only do them once a week and I won’t be held responsible if your tube ruptures and you lose it. I don’t advise this option, but it’s there. Just go to the hospital with any pain if you choose this route. Finally, we can send you to maternity triage for a dose of Methotrexate. This is the only option I’d recommend.” We asked for a beta the following day, and promised to go to triage if the number hadn’t risen appropriately. As the doctor walked out the door she said, “Don’t cry. I’ll see you back here soon enough!” That was the last time I ever saw that doctor.

On November 18, 2011, I walked into the women’s health wing of our local hospital pregnant. I left a few hours later with chemotherapy flowing through my veins. The same drug that is used to kill rapidly growing cancer, was being used to kill my likely wayward embryo. Two days later, after passing out on our bathroom floor, I was back to maternity triage. I was bleeding heavily and experiencing my first miscarriage. As the nurses got an IV started in an attempt to correct my barely perceptible blood pressure, I started having contractions. After I passed a large sac, it was scooped up and deposited in the nearest biohazard container. I wish I knew then what I know now. That passing a sac like that would be highly unlikely with an ectopic. That I could have requested to have those products tested. That an empty uterus via an ultrasound done at the 5-week mark couldn’t conclusively prove an ectopic. That the Methotrexate would curb all trying to conceive attempts for three full months. That in those months I’d find my tubes were blocked, that I had endometriosis, that I was far more fucked than I ever thought. That that embryo was my miracle child, forged out of the unlikeliest of scenarios and the last true pregnancy I’d see for a long while. But, we can’t live our lives through what if’s.

Save for one, that is. Today I find myself thinking, “What if things had gone differently? What if that embryo had become fetus had become baby had become my longed-for child?” Today would be my son or daughter’s first birthday. Happy birthday little one.

Happy birthday, little lost baby. What a beautifully detailed remembrance of this pregnancy. I also had an ectopic pregnancy, and it is a terrible loss because you can’t help but think, “what if you had just gone to the RIGHT place?” My experience was particularly puzzling because it was after an IVF, where they put the embryo IN YOUR UTERUS. I wish that the ultrasound place you went to had the fancypants ultrasound that was available to me–they could actually see the sac in my tube and confirm the ectopic. The not knowing for sure what truly happened must be maddening, to say the least. If it helps at all, my wacky beta pattern followed yours (except it started out low and eventually climbed to 1161 on the day before they took my tube and the sac inside at 6.5 weeks…I kept holding on to the hope that it was a weird but viable pregnancy and so did my clinic). It was strange and unpredictable and didn’t make sense. I hope that celebrating this little life lost helps you to heal and move into your next steps, where hopefully they can navigated through the “fucked” and get you to success! Thinking of you on this day of sadness and hope because there was a pregnancy, it can happen. I hope the stars align for you soon.

Yea, there are just so many questions and so many “what ifs” — not the least of which is whether or not it was even an ectopic in the first place. I keep saying “my ectopic” and describing it as such to doctors and others, but mainly it’s because I can’t even fathom accepting the other alternative. That it was simply a uterine pregnancy with slow and low HCGs. Having a pregnancy that survived until 8 wks with similar slow and low betas and P4s didn’t help the constant questions… :-/

I’m so sorry for your loss, and so very appreciative for your kind and clearly heartfelt words.

Yea, my GP will do both of those (or, in the case of a mammo, order it from the appropriate imaging place). If/when we end up child free I’m done with OBs for good — too much of an emotional landmine!!